Abstract
In July, 2011, the Canadian Diabetes Association updated the 2008 clinical practice guidelines to include the use of glycated hemoglobin (A1C) for the diagnosis of diabetes mellitus type 2 (DM2) in adults. One of the caveats is that “A1C may be misleading in certain ethnicities…, and therefore its utility as a diagnostic tool in these populations is unclear.” Alberta is multicultural and General Practitioners (GPs) diagnose the majority of DM2. Alberta's ethnic population: Canadian census data from 2006 (the latest available) indicated the top non-European ethnicities were First Nations, East and Southeast Asian, Chinese, South Asian and East Indian. Among visible minorities, non-First Nations groups also included Filipino and African. Use of glycated hemoglobin (A1C) to diagnose diabetes mellitus type 2 (DM2): First Nations, Asian and African ethnicities have A1Cs that are higher than those of European descent for a given glycemia, whereas Asian Indians have lower A1Cs. Thus, the present A1C cut-off will potentially over diagnose DM2 in the former populations, and under diagnose it in the latter. Thus, it is important for General Practitioners (GPs) not to rely solely on A1C for diagnosis of DM2.
